OBJECTIVES: The primary purpose of this study was to determine the prevalence of current and past estrogen use among older, community‐dwelling, postmenopausal women. The secondary purpose was to describe factors associated with estrogen use in this population.DESIGN: A survey.SETTING: The Piedmont region of North Carolina.PARTICIPANTS: The sample included 2602 community‐dwelling women over the age of 65 who were interviewed for the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE).MEASUREMENTS: Current and past use of estrogen.RESULTS: Of the women surveyed, 6.1% reported current estrogen use, and 18.5% reported past use. Approximately half of the participants reported using estrogen for more than 2 years. Multivariate analysis demonstrated that current estrogen users were younger, more affluent, had smaller families, and were more likely to be white and to live in an urban area than were never users. Current users were also more likely to drink alcohol and to take calcium supplements; and compared with past estrogen users, they were more likely to be white, have smaller families, and to drink alcohol.CONCLUSION: Estrogen replacement therapy is used by a small minority of older women, especially blacks. Moreover, although women with some risk factors for osteoporosis are more likely to use estrogen, the chief determinants of estrogen utilization are socioeconomic.J Am Geriatr Soc 44:1–6,